Pagano S, Franzoso F, Pachera F, Ruggeri P, Sorboli G
Divisione di Urologia, Ospedale Niguarda Cà Granda, Milano.
Arch Ital Urol Androl. 1996 Feb;68(1):39-45.
T1 G3 bladder carcinoma are classified as superficial tumours and treatment results are included in low stage tumour groups. A review of survival rates shows that there is a high risk of progression about 50-70%. The grade is by now considered the most significant prognostic factor and many other prognostic biological tests have been suggested. We treated 41 cases of T1G3 bladder tumours with a first therapeutic TUR and second staging TUR two months later. Subsequently a group of 15 has had "wait" and see" endoscopic follow-up with bad results, a group of 7 underwent "early cystectomy", a group of 12 has been treated with adjuvant cytotoxic chemotherapy with poor results on recurrence and good results on progression percentages, a group of 6 radiotherapy with poor results. We got confirmation of high risk of progression, 4 cases with high stage from beginning, 3 with precocious metastatic disease. Apart the cases with precocious metastases, the best survival rates are achieved with early cystectomy.
T1 G3期膀胱癌被归类为浅表性肿瘤,治疗结果被纳入低分期肿瘤组。生存率回顾显示,进展风险较高,约为50%-70%。目前,分级被认为是最重要的预后因素,并且已经提出了许多其他预后生物学检测方法。我们对41例T1G3期膀胱肿瘤患者进行了首次治疗性经尿道膀胱肿瘤切除术(TUR),并在两个月后进行了第二次分期TUR。随后,一组15例患者进行了“观察等待”的内镜随访,结果不佳;一组7例患者接受了“早期膀胱切除术”;一组12例患者接受了辅助细胞毒性化疗,复发结果不佳,但进展百分比方面效果良好;一组6例患者接受了放疗,结果不佳。我们证实了进展的高风险,4例从一开始就处于高分期,3例患有早熟转移性疾病。除了早熟转移的病例外,早期膀胱切除术的生存率最佳。